Nutrition Perfected NYC
 
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The virtues of omega-3 fatty acid supplementation are myriad, including reduced risks for heart disease, hypertension, and certain cancers, to name just a few.  Omega-3s are also essential for optimal nervous system and cognitive development in infants.  Unfortunately, the typical American diet is severely lacking in eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the two types of omega-3s that the body can easily use.  Our generally low dietary consumption of omega-3s puts EPA and DHA at the top of my list of favorite supplements.  While it's not appropriate for everyone, especially those with bleeding disorders and people who take certain medications, omega-3 supplementation offers unique benefits to a vast majority of the population with little risk of side effects.

Just in case you weren't convinced yet, a new study has discovered another surprising positive effect of omega-3s in the diet, this time specifically for our male readers.  A group from the University of Illinois has found that DHA is imperative for the proper development of effective sperm in mice.

Mice born without the ability to produce an enzyme allowing for endogenous (within the body) synthesis of DHA proved infertile when they also were fed a diet that lacked DHA.  When their diet was then supplemented with DHA, the mice became fertile.

The researchers found that DHA is required for proper sperm maturation.  When DHA is absent, a critical part of the sperm called the acrosome is not formed correctly.  The acrosome contains enzymes that allow the sperm to penetrate the egg.  With a malformed acrosome, the sperm is unable to enter the egg and fertilization fails.

While this research is obviously too preliminary to be generalized to humans, it brings up the interesting possibility of a link between some cases of male infertility and low DHA in the diet.  It remains to be seen if the findings in mice hold up when it comes to human subjects, but I think that many of us should continue to follow this rather important story.

The abstract of the original article, published in the October 2011 issue of the journal Biology of Reproduction, can be found at http://www.biolreprod.org/content/85/4/721.abstract.

 
 
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A new study published in the January 2012 issue of the journal Health Affairs brings to light some of the lesser-known, yet disastrous consequences of diabetes on the lives on young people in the US.  The physical complications of living with the disease have been clearly communicated by the medical community as well as the media.  However, relatively little information has been disseminated regarding other long-term, detrimental effects of diabetes on the lives of sufferers.  In their report, Jason Fletcher and Michael Richards of the Yale School of Public Health show that diabetes in young people negatively affects not only corporeal health, but also academic achievement and lifetime earning potential.



Some highlights (lowlights?) of the study:
  • The high school dropout rate is about 6% higher for those with diabetes compared to those without.
  • The lifetime earnings penalty of diabetes, assuming a 40-year working life, is at least $160,000.
  • Having a parent with diabetes reduces the likelihood of a child attending college by 4-6%, regardless of the child's health status.
  • Having a father with diabetes reduces a child's likelihood of employment at age 30 by about 7%.
The impact of the high school dropout rate on our nation is significant.  According to estimates cited in the Health Affairs study, each high school dropout costs society an extra $243,000 to $388,000 over their lifetime.  With the rising rates of childhood obesity and diabetes in the US, the detrimental effect of diabetes on educational outcomes could result in a heavy national financial burden above and beyond the more obvious and already economically deleterious direct healthcare costs related to the disease (which are also out of control).

The surprising inter-generational effects of diabetes on education and employment seen in this study show that diabetes harms not only the individual sufferer, but also his or her children.  Keep in mind that a child with one or two obese parents is 50% and 80% more likely, respectively, to be obese himself and that obesity is a leading risk factor for diabetes.  Together, these data indicate that obesity and diabetes can create a cascade of negative health and financial consequences lasting for generations within a family.

One caveat to this study is that it did not discriminate between Type I and Type II diabetics.  While this lumping together of data does leave a bit to be desired methodologically, I doubt if it has any significant implications regarding the study's conclusions.  Type I diabetes, which is an autoimmune disorder and is not linked to obesity, accounts for only about 5% of all diabetes cases.

If you're interested in reading the study in full, its abstract and access to full text options can be found at http://content.healthaffairs.org/content/31/1/27.abstract.

 
 
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_Childhood obesity is not a new problem for this country.  In fact, the percentage of obese children in the US has been rising steadily since at least 1980.  Recently, Georgia's Children's Healthcare of Atlanta brought a new level of aggression to the fight for the health of young people in their state through a print and TV ad campaign that has drawn both praise and condemnation nationwide.  The initiative, called Strong4Life, has a projected cost of $50 million dollars and will be rolled out over a five year period.

The print ads feature obese children with text such as, "Big bones didn't make me this way.  Big meals did," and "He has his father's eyes, his laugh, and maybe even his diabetes."  One TV spot shows a young, overweight boy sitting down across from his obese mother and asking, "Mom, why am I fat?"  The mother has no answer.

The imagery is striking, but one has to consider the fact that Georgia ranks second in the country for childhood obesity with over 1 million obese kids (that's 40%!!!).  Compounding the issue is that, according to a survey performed by Children's Healthcare of Atlanta, 50% of Georgia parents aren't aware that childhood obesity is a problem and that 75% of those currently raising an obese kid didn't think that their child had a weight problem.  Make no mistake, these numbers represent a public health crisis in Georgia.

Opponents to the PSAs say that the ads could increase negative stigma against obese children and that they seem to place the blame on the victim.  In a written statement, Ron Frieson, Chairman of the Obesity Action Coalition, an organization aimed at empowering the obese, said that "The messaging of the campaign is purely fuel for the fires" of bullying and abuse faced daily by obese children.  Other foes of the initiative expressed concern that the ads were simply offensive and offered no advice to help parents actually combat the problem.

I think that Children's Healthcare of Atlanta got this one right.  Obesity is one of the challenges of this generation.  The costs associated with rampant obesity represent a major threat to our way of life in the not-so-distant future.  Research has proven that obese children are far more likely to grow up to be obese adults.  We have to stop tiptoeing around the issue.  When 50% of parents in a region aren't even aware of the dangers surrounding childhood obesity, it's time to take drastic measures.

I'm well aware that people are often afraid of change, insulted by the idea of being told that they're doing something wrong, and hyper-sensitive to issues relating to personal choice.  But this is the new reality for our country and for an increasing percentage of the world at large.  The truth has to be communicated in powerful ways.  The soft approach CLEARLY hasn't worked.  Sensitivity has its place, but when the choice has to be made between bruised feelings and diabetic teenagers, I think you know which way I'll lean.

 
 
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_Back in February, I wrote about the January release of the USDA's 2010 Dietary Guidelines for Americans (DGA).  Included in the DGA were suggestions that should have positively affected the school lunch program in our nation's schools.

One new DGA requirement would have limited the amount of starchy vegetables (as opposed to their generally more nutritious fibrous brethren) served to one cup per week per student.  Another section proposed gradually lowering the salt in school lunches over 10 years from the current level of about 1,600mg per meal to 640-740mg per meal, with the ending level dependant upon the age range of the students consuming the food.  The DGA also mandated that half of all grains served in school lunches be whole grain.

Finally, the guidelines aimed to end the special treatment of tomato paste.  An eighth of a cup of tomato paste is counted as a full serving of vegetables (yeah, I know), as opposed to other fruit and vegetable purees and pastes that require a quarter cup to count as a full serving.  Tomato paste is put on this pedestal not because of any compelling dietary distinction but because of its prominent role in that school lunch classic: pizza.  In essence, pizza is currently counted as a serving of vegetables.  A bit ridiculous, no?

Fast forward to last month, when fiscal appropriations bill HR2112 was brought before Congress, dragging along with it a number of "riders" effectively negating the changes to be made to school lunches due to the 2010 DGA.

First, the bill disallows the limitation on starchy vegetables, even if they are to be replaced with healthier, fibrous options.  Not surprisingly, there was clear influence by commercial interests on this issue.  Regarding HR2112, Kraig R. Naasz, president and CEO of the American Frozen Food Institute said, "Of particular interest to frozen food producers, this agreement ensures that nutrient-rich vegetables such as potatoes, corn and peas will remain part of a balanced, healthy diet in federally funded school meals.”  Nice job, Mr. Naasz.  Clearly looking out for the best interests of our children and the country.  Potatoes, corn, and peas are far from the most nutrient-rich vegetable options out there, unless of course by "nutrient-rich" you just mean "relatively high carbohydrate content."

In addition, HR2112 severely limits the sodium reduction plan.  Again, it appears (to me) as though industry has lined politicians' pockets to get what they want.  Lori Roman, president of the Salt Institute, said, "We should not subject our school-children or any of our citizens to what amounts to a giant lab experiment.  [. . .] There are negative health consequences of a low-salt diet.”  Yes, Ms. Roman.  Surely the USDA reviewed zero literature before posting its guidelines.  Coming from the...Salt Institute, I'm sure your opinion on salt reduction in the National School Lunch Program is entirely unbiased.

Unfortunately, HR2112 was signed into law by the president near the end of Novermber.  In response to HR2112's passage, Margo Wootan, nutrition policy director at the Center for Science in the Public Interest, said, "Together, the school lunch riders in the agriculture spending bill would protect industry’s ability to keep pizza and french fries on school lunch trays every day of the week to the detriment of children’s health.  [. . .] Pizza should be served with a vegetable, not count as one."  Though I usually lampoon the CSPI for their often outlandish opinions, I'm happy to see that they've returned to planet Earth and ventured out of their UFOs for this battle.

The CSPI isn't the only one to voice disapproval.  To their credit, the USDA is standing their ground.  Following the signing of HR2112 into law, the USDA said, "While it's unfortunate that some members of Congress continue to put special interests ahead of the health of America's children, the USDA remains committed to practical, science-based standards for school meals."

The detrimental effects of this bill on the nutritional well-being of school kids, along with the obvious (and increasingly common) encroachment of commercial influence on the political process, makes the story of HR2112 especially disturbing.  School nutrition should be domain of science, not industry.  I applaud the USDA for making some progress with this year's DGA, but I'm disgusted by the lawmakers responsible for the passage of "roadblock" HR2112.

Maybe next year we'll start standing up for the future of our country.

 
 
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In a follow-up to my (very negative) article from March on the "hCG Diet," I thought it worthwhile to report that the FDA has finally deemed hCG products sold over the counter for weight loss as "unproven and illegal."  Along with the FTC, they've sent warning letters to a number of hCG product manufacturers.  The companies were given 15 days to notify the FDA of their corrective actions in regards to the violations stated in the warning letters.  If they ignore the warning, the manufacturers are subject to injunction, product seizure, and criminal prosecution.

While the FDA often pussy-foots around with questionable food and supplement products, I'm happy to see them standing up for consumers in this instance.  Will this be the end of decades of misleading and harmful hCG products pushed on the public in the name of weight loss?  Doubtful...but it's a start.

On the other hand, these warning letters, released on behalf of two relatively well-respected governmental bodies, might just spur some consumers to start critically evaluating foods, supplements, and drugs before they buy them.  Now that would be some real progress!

Courtesy of our friends at the FDA: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm282334.htm

 
 
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Overweight and obesity in children are especially disturbing as these early problems have been strongly linked to adult overweight and obesity.  In addition, research shows that children who become overweight before the age of eight are at risk for more severe obesity as they become adults.  Given the common progression of overweight and obesity through the life cycle, early prevention is key to improving both public health and decreasing the long-term, weight-related healthcare burden facing America.

In a post this morning, CNN's Elizabeth Cohen shows that, despite the obvious and serious issues regarding childhood obesity, food manufacturers appear resistant to positive changes.  Proposed government guidelines recommending lower sugar levels (among other things) in foods marketed to children have received a harsh response from the food industry.

Cohen cites a Kellogg's claim that they've lowered sugar by about 16% and that breakfast cereals contribute less than 4% of added sugar to the US diet.  A couple things to keep in mind here: a 16% decrease in the 15 grams of sugar currently formulated into the Honey Smacks product amounts to all of (drum roll...) 2.4 grams.  Hardly a meaningful amount in terms of a typical breakfast.  Also note that the 15 grams of sugar currently in the product is apparently the result of the aforementioned 16% reduction, giving a historical value of approximately 18 grams of sugar per serving.

Kellogg's VP of nutrition also took issue with the government report because it assumed the serving of cereal to be a cup.  The Kellogg's Honey Smacks product mentioned in the CNN post currently lists 0.75 cups as its serving size.  What's interesting is that other, somewhat less sugar-packed Kellogg's breakfast cereals DO list a full cup as their serving size (Frosted Mini-Wheats, Smorz [great concept there, Kellogg's], and even Fruit Loops).  If Honey Smacks had a one cup serving size, it would have to list its sugar content as TWENTY (20!) GRAMS per serving.  My guess?  Kellogg's is just betting that the general consumer won't bother to look at the serving size and will (at the very most) just scan the sugar content.  Now there's honesty in advertising...

The best part of the whole story is that the government recommendations aren't even binding; they're voluntary!  And yet, the industry refuses to get on-board.  Fixing childhood nutrition is going to be essentially impossible until both parents and industry leaders accept that there is in fact a problem and that both parties are responsible for its resolution.  Food manufacturers have to be willing to make significant changes to their products and parents have to be disciplined enough to teach their children how to feed themselves properly.

According to the CDC, almost 20% (ONE OUT OF FIVE) of children aged 6-11 (YOUR FIRST THROUGH SIXTH GRADERS!) and 18% of adolescents aged 12-19 were obese in 2008.  These numbers will socially and financially hamstring this country as these kids grow up.  The time for change is now.  Don't make excuses.

CNN Article: http://thechart.blogs.cnn.com/2011/12/07/sugar-is-on-the-menu-for-kids-breakfast/?hpt=hp_c3

P.S. A note for the somewhat more scientifically-oriented among us: research published in the International Journal of Obesity late last year adds another dire twist to this story.  Dr. Molly Bray of the Baylor College of Medicine led a team that investigated the effects of meal timing and nutrient balance on metabolic pathway preference and body composition in mice.  Essentially, they discovered that eating a breakfast high in carbohydrates reduces "metabolic plasticity," the ability of your body to adapt to processing non-carbohydrate nutrients (e.g. fats) later in the day.  High carbohydrate breakfasts led not only to increased fat gain but also classic symptoms of metabolic syndrome.  You can read the complete publication in all of its full text glory thanks to NIH: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021134/

 
 
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_In January, I gave a basic overview of the new mandatory nutritional labeling requirements set out in the healthcare reform bill of 2010.  I explained my position in support of this aspect of the wide-ranging healthcare bill and attempted to counter some of the common arguments given against mandatory restaurant and vending machine nutritional labeling.

Since then, a number of articles have been published in popular media outlets conveying the results of a number of studies that looked at the efficacy of the new labeling regulations on the consumption patterns of the general public.  Without exception, the studies have shown, at best, minimal improvement in the amount of calories consumed by restaurant patrons.

One study, performed by researchers at NYU and Yale University, looked at how calorie labels on menus at fast food restaurants affected the purchasing decisions of patrons in low-income neighborhoods of New York City, where obesity rates are especially high.  Customer surveys indicated that about half of the diners had noticed the calorie count labels and about 28% of those that noticed said that the labels had made an impact on their food order.  However, when the researchers analyzed the customer’s receipts, they found that the number of calories per customer was actually slightly higher than the average patron before the labeling requirements became law.

Another study, led by Dr. Brian Elbel from NYU’s School of Medicine, surveyed children and adolescents in NYC who bought food from fast food restaurants.  While the surveys showed that 57% of the subjects had noticed the calorie labels, only 9% said that they took the calorie counts into consideration when ordering.  It’s also worth mentioning that the study found that 35% of the study participants consumed fast food six or more times per week and that 72% ranked taste as the prime factor when choosing a meal.

A third study was conducted in King County, Washington, at a Mexican food chain called Taco Time.  Only Taco Time locations within the county are required to put calorie counts on their menus.  Those outside the county are subject to no such regulation.  After 13 months of mandatory calorie labeling, researchers found no difference in the average calories per order between locations inside and outside King County.

These studies are commonly cited by critics of restaurant labeling laws as evidence that these regulations are useless in helping combat the obesity epidemic.  However, when one considers how consumers might utilize calorie labels on menus and the ways in which changes in dietary habits will likely filter through the population, it becomes clear that these assessments must be taken with a grain of salt.

The first issue with these three studies is that the time period between the introduction of restaurant labeling and the start of the investigation may be too short for consumers to fully consider and take into account the data the labels provide.  Each of the first two studies mentioned previously found that only around half of the total number of patrons even noticed the labels.  With only half of study subjects even aware of the new information source, it seems a bit irrational to judge the effectiveness of the labels.  Indeed, the problem highlighted in these studies wasn’t with the labels themselves, but with the marketing and advertising of the new displays.  Consumers need more time and more help in order to fully take into account the information communicated by the nutritional labels.  A higher percentage of patrons must be aware of the new signage before its calorie-reducing effectiveness can be accurately assessed.

The second limitation of the current crop of studies is that they looked at very specific populations in very specific (and homogenous) environments.  All three studies were conducted at fast food restaurants.  Two of the studies were performed in NYC and used subjects with low discretionary incomes.  Generalizations derived from the results of the studies and applied to the national question of restaurant calorie labeling must be called into question, considering that all of the studies utilized similar restaurant types and subjects whose choices were likely influenced most strongly by price.  In order to make logically sound generalizations on the concept of mandatory labeling, more diverse data are required.

Future studies looking at the efficacy of nutritional labeling should include traditional, non-fast food restaurants, subjects from all areas of the country, and members of various socioeconomic classes.  Only then can we assess the true national impact of mandatory nutritional labeling in restaurants.

We need to allow more time for the habit of reading and considering nutritional labels to take hold in the minds of consumers.  Better marketing and advertising of the new signage would likely speed up that acclimatization.  In addition, time must be allowed for mothers, fathers, and other caregivers to communicate to children the importance of the new labels.  While these signs and the data they display may seem new and foreign to many people who have always chosen their food by taste or price alone, imagine the perspective of a teenager who, in the year 2025, has grown up seeing the labels on every menu.  The instinct to consider the nutritional content of food may be then just as natural as our current foci on price and taste.  It’s going to take time for our culture to adapt to the new labeling information, so let’s not throw out a great concept because of a knee-jerk reaction to immature research findings.

 
 
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Sodium intake has been a major issue in nutrition and public health for quite some time.  The American diet (as well as those of many other nations) is notoriously high in sodium with staple foods like processed meat products, potato chips, and take-out food.  It’s been widely communicated to the public that high sodium intake can cause high blood pressure, also known as hypertension.  However, this message has often failed to reach many people who don’t currently suffer from hypertension and therefore believe that sodium reduction is not important to their health.  Let’s explore the mechanism behind the link between sodium and hypertension as well as some of the other risks associated with a high sodium intake level.

Salt is extremely hygroscopic, meaning its molecules attract water from the surrounding environment.  High dietary salt intake causes an increase in the concentration of sodium in the blood.  In order to dilute the blood back to an appropriate level, water is pulled out of other areas of the body and into the bloodstream.  The increase in blood volume stresses blood vessels, which respond by thickening their walls.  As the blood vessel walls thicken, the space through which blood can flow decreases.  The heart is forced to pump harder in order to get enough blood around the body, leading to high blood pressure.

One consequence of chronic hypertension is left ventricular hypertrophy (LVH).  LVH is an enlargement of a portion of the heart muscle due to an increase in the pressure it is required to pump against.  Studies investigating the direct link between LVH and sodium intake have shown that in people who have already developed LVH, decreasing dietary sodium can significantly lower left ventricular mass within one year.  In addition, those with more severe LVH show the greatest benefit from sodium reduction.  Clearly, there is a causative relationship here that may be able to help those suffering from dietary sodium-induced LVH.

High sodium intake can also put your bones at risk.  As dietary sodium increases, so does urinary calcium excretion.  Sodium and calcium compete for the same reabsorption mechanism in the kidneys.  As sodium output due to overconsumption goes up, less calcium is able to reabsorbed, leading to greater than normal losses in calcium.  Though there are other nutrients that can affect urinary calcium output, it has been shown that sodium is the primary nutritional factor.  Low dietary calcium also tends to exacerbate the problem, so it may be wise for those with higher sodium diets to keep an eye on their calcium intake.

Not only does increased urinary calcium excretion cause problems for bones, but it also increases the risk of kidney stones.  In fact, high salt levels are even implicated in rising rates of childhood kidney stones!  For anyone who’s ever had a kidney stone can attest, it sucks.  Don’t let salty food be the cause of this excruciating disorder.

Another more direct risk to the kidneys exists, as well.  High blood pressure can damage the kidneys’ vascular system, resulting in what’s known as hypertensive nephrosclerosis (HN).  HN accounts for at least 25% of patients suffering from end-stage renal disease (ESRD).  It is the second most common cause of ESRD in Caucasians and the leading cause in African-Americans.

Beyond the heart, bones, and kidneys, even more bad news awaits for the heavy sodium consumer.  A high salt diet has been shown to assist Helicobacter pylori, the bacteria associated with 90% of duodenal ulcers and 80% of gastric ulcers.  A high salt environment increases the expression of two genes in H. pylori that produce proteins associated with the bacteria’s virulence.  Essentially, your salt shaker lends a helping hand to the survival of the microorganism that’s most likely responsible for punching holes in your gut.

Even worse, high dietary sodium levels have been shown to be significant risk factors for both gastric and colorectal cancers.  Whether or not H. pylori plays a role in the increased incidence of the former cancer remains to be determined.  However, it’s clear that with or without the bacteria, chronically high salt intake will raise your chances of getting some very nasty cancers.

So, the upshot here is that sodium reduction is for pretty much everyone.  Everyone, at least, who cares about their heart, bones, kidneys, stomach, or risk of getting cancer.  There’s more to the salt-reduction campaign that hypertension.  So, whether your blood pressure is high, low, or just right, keep in mind the other risks of a high salt diet and look for alternatives to those foods in your diet that are loaded with sodium.

 
 
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The hCG diet is a protocol that combines extreme caloric restriction with injections of human chorionic gonadotropin, a hormone associated with pregnancy.  The diet has been around for over 50 years and is currently promoted by many companies, mainly online.  However, despite its enduring popularity, it has been proven by numerous well-executed studies, over the course of decades, to be not only ineffective as a long-term weight loss solution, but also dangerous.

The hCG diet prescribes an intake of just 500 calories per day, along with injections or, more commonly these days, drops that contain hCG.  While it’s true that one will most definitely lose a ton of weight due to extremely low energy consumption, there are a number of significant risks involved in the practice.

Possibly the most serious complication is cardiac dysrhythmia.  Heart-related disturbances have been noted following very low calorie diets since the 1970s.  The risk of developing gallstones is also raised.  In one study, 11% of subjects following a very low calorie diet developed gallstones.  That is a very high percentage.  Hyperuricemia (high uric acid levels in the blood) and gout are also a well-established risk when following a very low calorie diet.

One of the major problems with an extremely low calorie diet such as the hCG protocol is that they are generally unsupervised and provide almost no room for error.  Consumption of only 500 calories per day would make it almost impossible for most people to maintain proper levels of essential amino acids, vitamins, minerals, and other micronutrients required for good health.  Another common problem seen with these highly restrictive diets is the development of electrolyte imbalances.  In fact, this issue may be at least partly to blame for the cardiac irregularities associated with very low calorie diets.

Besides major medical crises, deficits in essential nutrients can lead to a number of other problems.  Hair loss, dry skin, and weak nails are just some of the symptoms likely to occur with an extremely limited diet.  Antioxidant and other phytonutrient intakes will also be severely restricted.  After all, food contains the compounds we need for health.  How can one expect to maintain their body when consuming almost no food?

There’s also the claim that the hCG injections make the diet safer.  Since the birth of the hCG diet in the 1950s, over twelve well-designed and properly executed studies have evaluated the effect of hCG supplementation in combination with an extremely low caloric intake.  Without exception, they found that hCG was of no more use than an injection of saline.  It did nothing to make the diet safer nor did it accelerate weight loss.  That’s a pretty solid body of evidence.

While the studies in question used high-concentration hCG injections, most supplements on the market today contain relatively miniscule amounts of the hormone.  When 50 years worth of research shows that even high doses of hCG do nothing to aid weight loss, why would anyone believe that low-concentration snake oil will do any better?  Truly a scam, if there ever was one.

Finally, it’s worth noting that the FDA has come out and unequivocally stated that that “homeopathic” hCG supplements are fraudulent and are being sold illegally.  While the FDA is often slow to react and sometimes wishy-washy when it comes to controversial issues, they spoke plainly on this one.  If the FDA is willing to put its neck on the line to say something is completely bogus, it’s a pretty sure bet that it is.

Even before its recent statement aimed at low-dose, “homeopathic” hCG products, the FDA has long held a strong stance against the use of prescription hCG injections for the purpose of weight loss.  All hCG products have been required since the mid-1970s to carry a warning statement informing the buyer that hCG is not approved by the FDA for the treatment of obesity or weight control and that there is no evidence indicating that it will increase weight loss, decrease hunger or discomfort while on a very low-calorie diet, or cause a more “normal” or attractive distribution of fat.

The hCG diet has been around for over 50 years.  In reality, it is simply a very low calorie diet that companies have timelessly associated with an expensive snake oil.  Decades of excellent research have proven that hCG does nothing to increase the safety or efficacy of a very low calorie diet.

In addition, the use of such an extreme diet, with or without hCG supplementation, has been shown to be a very risky proposition.  Restricting calories under about 1200-1500 per day is rife with problems, from external problems with hair and skin to the potentially deadly malfunctions of multiple internal organs.

Finally, very low calorie protocols like the hCG diet have also been proven to be poor long-term solutions for weight control.  Subjects almost always regain the lost weight, often with a higher proportion of fat to muscle.

The hCG diet is a money-making scheme that has successfully bilked thousands, if not millions, of honest consumers out of millions of dollars.  It’s a diet based on fundamentally flawed science that uses unregulated, illegal, and useless dietary supplements.  Don’t fall prey to this decades-old lie.  Take responsibility for your life and make the right changes to lose weight in a healthy manner.

 
 
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The concept of taxing certain food products more than others in order to sway consumers away from unhealthy products is an intensely controversial issue.  Proponents of the food tax say it is necessary to protect the economy and public health.  Interestingly, opponents of the concept claim that a food tax will HURT the economy and will do nothing to help counter the epidemic proportions of overweight and obesity that we are currently experiencing in this country and throughout the globe.  So who’s right?  Let’s sift through some of the arguments and apparently contradictory statistics quoted from both sides of the debate and look for the kernel of truth.

One argument for food taxes is simply that nothing else seems to be working.  While many people from diverse locations on the political spectrum are wary of government intervening too deeply into the personal lives of citizens, it has become evident that the obesity train wreck in the US is not going away any time soon.  Dr. William H. Dietz, director of the division of nutrition, physical activity, and obesity at the US Centers for Disease Control and Prevention, was quoted in 2010 as saying, “I don’t think we have in place the kind of policy or environmental changes needed to reverse this epidemic just yet.”  Clearly, something needs to be done to fix the problem.  Food taxes are one possible answer.

Another line of evidence in favor of a food tax comes from research studies looking at the interaction between the price of unhealthy foods and consumption patterns of those products.

One such study, published last year, evaluated how the price of pizza and soda affected the buying preferences of young adults.  The researchers found that a 10% increase in the price of soda decreased its caloric contribution to the participants’ diets by over 7%, on average.  In the case of pizza, a 10% increase in price led to an 11.5% drop in its caloric contribution.  Additionally, soda and pizza prices were also found to significantly affect total caloric intake and body weight.  That finding indicates that the calories NOT consumed by way of pizza and soda weren’t simply replaced by those from other sources.  Instead, they were simply not consumed.

Another recent study from the Netherlands looked at how college students’ lunchtime preferences were affected by 25% and 50% taxes on high-calorie items.  The research team found that the students decreased their overall caloric intake from the meal by 100-300 calories, depending upon the tax level.

A similar study actually put taxes like those seen in the Netherlands study to a real-world test.  A Boston hospital instated a 35% tax on sugar-sweetened sodas sold in their cafeteria.  The investigators found that sales of the taxed beverages fell by over a quarter and that consumers generally substituted coffee or diet sodas.

Finally, a study published last year by the USDA’s Economic Research Service (ERS) found that a 20% tax on sugar-sweetened sodas could reduce the prevalence of obesity by almost 10%.  While that may seem like a relatively large tax for a relatively small decrease in obesity, consider that this study only evaluated the effect of taxing a single type of “unhealthy” food.  If a similar tax was applied to other foods, an even greater decrease in obesity would be likely, as was observed in the Netherlands study of pizza and soda prices.

Clearly, there is scientific evidence supporting the institution of food taxes.  However, as the saying goes, one can find statistics to support anything!  Indeed, the opposition to food taxes has done a pretty good job at finding some numbers to support their view on this contentious issue.

One study referenced by the anti-food tax faction was performed at George Mason University (GMU) and examined whether the food tax would accomplish its goal of curbing obesity and how the economics of the tax would impact various demographic groups.  The researchers concluded that sugar-sweetened soft drinks only accounted for a “trivial” amount of calories in the overall diet.  They also pointed out that a tax on such beverages would likely be regressive, meaning it would negatively impact the poor more intensely than it would the rich.  Because the poor spend a higher percentage of their earnings on food, any increase in food price will hit them harder.

There are a couple of problems with the GMU group’s analysis.  First, what these researchers consider a trivial amount of calories may actually be enough to make a significant difference for many people on the border of overweight, obesity, or diabetes risk.  In the GMU study, many of the examples given were of the tax’s effect on very overweight individuals.  While a small tax on sodas will not be enough to solve serious problems like those, it can help people in less extreme, but still serious, situations.  A study on overweight adults found that each kilogram of weight lost over a ten year period led to a 33% lower risk of diabetes in the subsequent ten years.  In addition, each kilogram of weight gain was associated with a 49% increase in diabetes risk.  Not so trivial, eh?

With regards to the claim of a tax on sugar-sweetened beverages being regressive, it’s true.  Without any other considerations, such a tax would likely be relatively more injurious to lower-income individuals and families.  However, in addition to the tax, a complimentary subsidy program has been proposed that would use the funds generated by the tax to make healthy foods more affordable.  This subsidy could even be designed to primarily benefit the poor.  With this offset taken into account, the regressive nature of the tax seems to be an economical non-issue.

Other studies cited by those opposed to the food tax note that physical activity is also imperative to maintaining proper body composition.  Anti-food tax groups have proposed and even implemented a number of youth-oriented fitness and exercise programs to show their support for childhood exercise promotion.  While they do make a valid point regarding the necessity of exercise for the maintenance of optimal health and fitness, they seem to use it as a reason for not also addressing nutrition in public health policy.  The human body requires both proper nutrition and exercise, not only one or the other, to perform at its best, both physically and mentally.  Playing one side of the coin against the other indicates either an extremely uninformed perspective on the subject of human health or simple bias.  I’d tend to suspect the latter.

Besides the issues covered here, there are other considerations to address, such as food industry cooperation with the application of any new taxes.  For the taxes to have the desired effect of lowering the public’s consumption of certain products, the industry would have to pass the increased cost onto the consumer.  Unfortunately, food companies could instead choose to simply absorb it or distribute it evenly throughout their entire product line.  Loopholes also exist through which local retailers may work to counteract the tax.  In fact, there are many facets to this issue that demand further research and refinement in order to make the tax as efficient and fair as possible.  But the potential problems with the implementation of a food tax should not stop us from considering it as a viable method to benefit public health.

Food taxes represent one potential tool to help turn the tide against obesity in the US.  While attention needs to be paid to the method of implementation and the breadth of application, the research supports the realistic benefits of the concept.  Research data show that a food tax, even a relatively modest and limited one, can make a significant and meaningful difference in the public health.  Let’s not be afraid to try something different.  Let’s not be swayed by the fear-mongering of those opposed to any sort of governmental action, even when it’s designed to counter the epidemic of our generation.  Let’s instead commit to making changes that produce real results.  A food tax can be a part of the obesity solution and it’s time to put forth effort to do it right.

 

    Author

    Rob Bent is the founder and lead nutrition counselor at Nutrition Perfected.  He is a multi-sport athlete and works constantly to maximize sports performance through scientifically-guided nutritional optimization.

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